Mental health money ‘fix’ will compound the problem

Kathy Day
Kathy Day

As relatives of people with schizoaffective disorder, we are outraged that Californians with serious mental illness continue to sleep under cardboard boxes, forage garbage cans for food and cower untreated in local jails despite the $13 billion in Mental Health Services Act funds raised over the last 10 years.

The Little Hoover Commission has just issued a report finding that part of the problem is that no one knows how the funds are being spent. The state auditor found the same thing in 2012, and a whistleblower reported it to authorities in 2009.

What is different this time is that the report proposes the worst possible “fix” by urging legislators to give the Mental Health Services Oversight and Accountability Commission even more power to regulate. That will compound the problem, not fix it. The oversight commission is the problem, not the solution.

Mental Illness Policy Org. analyzed the regulations that came out of the oversight commission and its predecessor agency over the past 10 years and found they are largely intended to drive money away from people with serious mental illness whom voters intended to help, and toward dubious social service programs for people without mental illness.

Regulations often prohibit counties from using some funds on people with mental illness – and encourage counties to use funds on programs that lack evidence that they are effective. The oversight commission refuses to collect data on the diagnoses of those served to ensure they have a mental illness that entitles them to services, or on reductions in homelessness, arrest, suicide and incarceration to see if the funds are being used effectively.

The oversight commission gave out at least $6 million to organizations that try to stop counties from implementing Laura’s Law, perhaps the most effective program California has for reducing homelessness and incarceration among the seriously mentally ill. On the other hand, it gave out an $11 million public relations contract to generate good press for its bad results.

Former Senate President Pro Tem Darrell Steinberg, who sponsored the act in 2004, told The Sacramento Bee that “data proving the act has worked would be delivered within six weeks.” But will the data be believable?

When the oversight commission hired UCLA to do a supposedly independent evaluation, board minutes show it specifically instructed the evaluators to “focus on positive results.” When the commission created a report on alleged savings, it intentionally overstated them.

This is not what voters were promised. Looking back on the campaign to get the bill passed, Rusty Selix, executive director of the California Council of Community Mental Health Agencies, said that voters “didn’t want to fund all mental health, only people that had severe mental illness.” Proposition 63 was written that way, but once the bill passed, the oversight commission encouraged the opposite – funding of “all mental health” and the shunning of “severe mental illness.”

Steinberg was relying on solid science when he promised voters, “We can’t prevent certain mental illnesses, such as schizophrenia and bipolar disorder, but we can prevent them from becoming severe and disabling.”

But the oversight commission overruled both science and Steinberg by encouraging counties to divert funds to improving grades, ending poverty and increasing employment – all under the guise that it would “prevent mental illness.”

It was a bait and switch that continues to this day.

The solution is to replace the industry insiders who are on the oversight commission with business executives, law enforcement officials, emergency room doctors and others who bear the consequences when the mentally ill can’t get treatment. Only two commissioners are required to be from the industry, but almost all the appointees are. Their actions have benefited their employers, not the seriously ill.

We don’t want Californians with serious mental illness to continue to suffer – or to read a 2016 report on “lack of oversight.” It’s time for the commissioners to go. There is no doubt that the Mental Health Services Act is helping the seriously mentally ill. There is also no doubt that hundreds of millions of dollars are being diverted elsewhere.

Kathy Day is an advocate and former member of the Sacramento County Mental Health Board. DJ Jaffe is executive director of Mental Illness Policy Org., a nonpartisan think tank.